Marcus’s Case Study
Marcus is a 38-year-old single gay man who says that his substance dependence and his bipolar disorder both emerged in his late teens about a year before he became aware of his same-sex attraction. He says that he started to drink to “feel better” when he was stressed out about keeping his sexual orientation a secret, and also when his episodes of depression made it hard for him to interact with his peers. He also states that alcohol and cocaine gradually became a natural part of his manic episodes. He also notes that coming off the cocaine and binge drinking contribute to low mood, but he has no interest in participating in a 12-step program because he doesn’t believe in a “higher power.” He attempted to use SMART Recovery online, but said it didn’t work for him. Yet, Marcus is now trying to make new friends since the death of his long-standing partner, and he says he is especially motivated to get a better handle on both his bipolar disorder and his substance use. He has been more compliant with his mood-stabilizing and antidepressant medication, and his psychiatrist would like his dual diagnoses addressed with psychotherapy.
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